Modern medicine is highly dependent upon medications to prevent, treat and ameliorate diseases and symptoms, including those of the eye. Such medications range from nutrients and vitamins, and other supplements, to prophylactic over-the-counter medications (such as antihistamines and lubricants) to medications for the treatment of diseases (such as glaucoma, retinopathies, uveitis, infections and corneal abrasions).
Many patients with diseases of the eye, and conjunctivae require applications of eye drops (often of different drugs from different dispensers/bottles) one or more times per day.
These eye drops can consist of antibiotics, steroids, prostoglandins, beta-blockers, alpha-andranergic agonists, Carbonic anhydrase inhibitors, Parasympathomimetics, Epinephrine, Hyperosmotic agents, antihistamines, various neuroprotective agents, anti-inflammatory agents, anti-angiogenesis agents, nano-particles, saline, vitamins, lubrication and many others components including existing drops which are already contain various combined medications.
Many patients under the care of an optometrist, opthalmologist or other clinician, take one or more opthalmic medications each day, and in some cases these treatments vary by each eye (i.e. different medications, dosing and timing required for each eye).
Poor compliance/adherence with ophthalmic drop prescriptions is a significant problem and is an increased challenge with the higher number and frequency of different eye drops prescribed. Poor compliance leads to many downsides, including increased disease burden and morbidity, need for surgical interventions (e.g., for glaucoma) and significant overall costs in care. Poor compliance often results in more rapid and/or progressive disease, deteriorated vision, and the need for expensive interventions including eye surgeries.
Compliance to prescribed medication regimens (often termed ‘adherence’) is often quite low, for example, as low as 50% or lower in many cases. Poor adherence is often exacerbated by complicated instructions, opthalmic drug dispensers (usually simple squeeze bottles) which are difficult to hold and dispense accurately, especially by the elderly. Poor vision, or visual limitations already present may also hamper the ability of the patient or a caregiver to identify visually and select the eye medication of interest, amongst several similar sized or appearing dispensing bottles.
Furthermore, especially in more frail or elderly patients, and those with any tremor or, other movement disorder, or forms of arthritis in the hand, the handling of relatively small eye drop containers can be challenging. The ability to appropriately place the eye drop container over the indicated (eye) and squeeze out an appropriate dose of liquid and having it appropriately administered as directed on the eye, is difficult, including the timing of the eye drop with an open eye, in order to assure the desired medication is delivered.
In addition, clinical trials, and the safety, efficacy measures required to develop new opthalmologic drugs and combinations often require extensive, rigorous and expensive and phased clinical trials. Assurance that trial subjects are actually taking the test drugs/placebo or other medical components is critical to accurate assessment and the potential success of the trials. Better means of tracking compliance during clinical trials will lead to safer, more effective ophthalmologic drugs entering the market.
Another issue of medication dispensation to the eye is the handling and measuring appropriate doses of liquid eye drop medications and delivering properly to the eye. This leads to inaccuracies and the likelihood of missed, under or over dosing.
Accurate dosing and tapering is particularly critical for more potent medications such as steroids and immunosuppressants (such as cyclosprin). Most of these drugs for patients with eye conditions are given outside of the hospital or clinic setting by the patient themselves, family members or other caregivers.
A better, more convenient, integrated method is needed for accurately delivering drugs to the eye, especially for drugs which must be dosed carefully and delivered accurately and regularly.